Frequently asked questions
Below are answers to some of the common questions that arise regarding ketamine-assisted therapy. We hope this is useful but please do ask one of our clinical staff if you have any further questions.
about psychedelic therapy
What is psychedelic therapy?
Psychedelic therapy refers to using drugs that alter consciousness, combined with psychotherapy, to offer patients the opportunity to address difficult psychological issues, supported by their therapist. The drugs, in combination with talk therapy, allow the patient to experience a deeper and more effective form of talk therapy.
Aren’t psychedelics drugs of abuse? How is this different?
Historically many drugs that have therapeutic benefits have been banned by governments. However, current research shows that many such drugs do have important therapeutic properties and can be used safely as treatments for a wide range of medical conditions. The way many drugs (e.g. cannabis, MDMA, psilocybin/ magic mushrooms, LSD and ketamine) are used recreationally is very different from how they are used in controlled medical settings. In the medical context, the drugs used are pure without adulterants and patients are closely monitored before, during and after drug sessions, making psychedelic therapy very safe.
What about scary or “bad” trips?
Psychedelic experiences with ‘classic’ psychedelic drugs (such as LSD or psilocybin) can be potentially challenging. But when used clinically the patient is always accompanied by an experienced therapist, who is there to help them through the experience. It is often through experiencing these challenges that the patient ‘breaks through’ and tackles rigid patterns of thinking, which have maintained their lifelong psychological issues.
Who are your providers?
All the medicines used are produced by legal chemists who specialise in manufacturing the highest quality clinical medicines that meet all the necessary regulatory approvals to be used with patients.
What conditions do you treat?
Depression, anxiety disorders, PTSD, eating disorders and addictions to multiple substances, including alcohol. Common to all of these conditions is often an underlying experience of past trauma and/or adversity - often going back to difficult childhood experiences. Psychedelic therapy is a good treatment for helping patients to address difficult past traumatic memories that they would usually avoid. Even if you have not experienced past trauma or adversity, this therapy can be particularly beneficial for helping you to gain new insights and perspectives to familiar problems.
Are there conditions that would exclude me from treatment?
Psychedelic drugs used clinically under monitored medical supervision are safe to use with most health conditions. However, some conditions would exclude you from treatment with psychedelics. People with unstable blood pressure, a history of cardiac disease, severe liver or kidney disease, pregnancy, breastfeeding, the elderly, children under 18 years old, people with a history of psychosis (e.g. schizophrenia or bipolar 1 disorder) or those with a high suicide risk will likely not meet the eligibility criteria for psychedelic-assisted therapy. However, every case will be assessed individually and discussed with our clinicians before deciding whether to proceed with treatment.
Do I need a referral? How can I get a referral from my GP?
You do not need a formal referral from your GP. Anyone may self-refer to the clinic to be assessed for possible treatment. We will need to see a record of your medical history (which you can request from your GP practice) so we can assess in advance whether you meet the criteria for a medical assessment for psychedelic-assisted therapy.
Is this treatment covered under the NHS?
At present, the NHS has not chosen to fund this kind of treatment. This is something we hope will change in the near future. The NHS often takes a long time to approve new treatments. For the time being patients (or their insurance companies) will have to self-fund the treatments.
How should I prepare for the treatment?
When you make your referral, you will be asked to get a medical summary from your GP. This will be reviewed by the medical team before you are invited for a face-to-face medical assessment. During visits for the treatment, you are advised to wear comfortable clothing. You may feel nauseous which is why you are advised to eat only a light meal before your ketamine administration. The other (non-drug) therapy sessions will be like ordinary outpatient therapy sessions.
What can I expect during the treatment?
The treatment consists of eleven sessions of outpatient therapy over a nine-week course. You will not be required to stay overnight for any sessions. On four occasions your therapy session will involve being injected in the arm muscle with a solution of ketamine. The dose will vary across the four drug sessions depending on your clinical progress and in collaboration with yourself. Some people may desire or require higher doses. Others may wish to stay on lower doses. You will have control over how the therapy progresses.
How will the ketamine be administered?
We will be using intramuscular (IM) injections of ketamine, which are given into the shoulder muscle - much like a vaccine is given.
What are the benefits of this treatment?
Ketamine can improve brain plasticity which means it becomes more interconnected. This can facilitate psychotherapy, as a person can more easily consider new perspectives to their difficulties. Thus, ketamine-assisted psychotherapy can help people to become ‘unstuck’ by adopting new, more flexible ways of thinking and behaving. It is important to put the new learning and insights from the therapy into practice in your daily life to maintain the benefits. Your therapist will support you to do this.
How long does a treatment visit take?
Non-drug sessions are 50-minutes long. The drug sessions are two-hours long. After each drug session you will be able to stay in the clinic until you feel able to leave to go home. You will not be able to drive yourself home after a drug session. We will request that you are accompanied home by a named individual whom you have identified in advance of starting the treatment.
How many visits will I need to make?
You will visit the clinic for an initial assessment to get a better understanding of whether this treatment approach is suitable for you. If you are eligible and wish to proceed, you will attend nine sessions over six weeks. You will have an integration therapy session the day after each ketamine-assisted appointment. Three weeks after your treatment course, you will be offered a follow-up appointment to see how things are going and discuss next steps. You can therefore expect to make eleven visits to the clinic in total.
Is ketamine safe?
Ketamine is very safe. It is used every day in casualty departments all over the world as a safe and effective anaesthetic for performing minor surgical procedures.
We will be using ketamine at much lower doses than it is used as an anaesthetic. All patients are carefully screened and fully monitored throughout. Safety is a priority.
How does ketamine work for therapy?
Ketamine is an NMDA-antagonist, working across multiple receptors in the brain. At very high doses it acts as an anaesthetic; putting you completely to sleep. At lower doses (as we use) it creates an altered state of consciousness that when combined with psychotherapy allows you to carry out effective and safe treatment. Ketamine is understood to increase brain plasticity (flexibility) and connectivity meaning it can help a person become more adaptive and open to new perspectives.
How long will it take for ketamine to be felt in my system?
The effects start after five minutes and last for around 90-minutes. You will be supported throughout the experience. You can then ‘chill out’ in our comfortable clinic surroundings before going home.
How does ketamine feel?
It is a “dissociative” drug, meaning the patient experiences a sense of detachment from their usual self. This is sometimes refererred to as an ‘out of body’ type experience. This experience, when combined with psychotherapy, it allows the patient to see their psychological problems in a new light and, together with support from their therapist, reflect upon and address their issues.
Is ketamine addictive?
In the lower, infrequent doses we use clinically there is a very low risk of addiction. However, in large, repeated doses (as some people use the drug recreationally) it is possible to become addicted to ketamine.
Does ketamine have any side effects or risks?
In the short term, you may feel somewhat dissociated (or ‘spaced out’ where your mind feels separate from your body). There is a possibility of some initial anxiety that will pass and you will always be supported by your therapist to help to manage this. People sometimes describe feeling a bit light-headed or dizzy. You may feel nauseous which is why we will advise you to fast for 6 hours before your ketamine administration. People often describe feeling tired afterwards so it is a good idea not to make plans for the rest of the day.
Much less commonly, people report feeling low in mood or manic immediately following treatment. You must let the clinical team know straight away if you notice these experiences so we can support you.
You will be closely monitored throughout your treatment and clinicians will use a questionnaire to monitor any side effects and how long they last (most typically
resolve within an hour). Ketamine administered in a clinical environment, alongside therapeutic support enhances safety.
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